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CALCIUM & BONE HEALTH
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Most people, especially females, are aware of osteoporosis and the role that calcium plays in it. This essay will review key health factors that affect the bones and steps to maintain bone health. It will end with a discussion of the newer prebiotics food fibers, especially oligofructose enriched inulin, and its newly discovered role in improving the bone health of young teenage girls.
Calcium
Calcium is one of the most common elements in nature and our bodies. Even so, we need a steady intake of calcium to maintain bone strength and prevent osteoporosis. Since this disorder is primarily a problem for females, they, in particular, should be aware of how much calcium they ingest each day. The U.S. Department of Agriculture recommends the following calcium intake:
| |
Age |
mg Calcium/day |
| Children |
1-5
6-10 |
800
800-1,200
|
Adolescents/
Young Adults
|
11-24 |
1,200-1,500 |
| Male Adults |
25-64
65+ |
1,000
1,500
|
| Female Adults |
25-49
50-64 (on estrogen)
50-64 (not on estrogen)
65+ |
1,000
1,000
1,500
1,500 |
Click here for the amount of calcium in various foods. Be sure you are getting enough.
Vitamin D
Vitamin D is also essential to bone health. It encourages absorption of calcium. You get vitamin D from exposure of the skin to the sun, from a limited number of foods, and from dietary supplements. A remarkable recent finding is that there are receptors for vitamin D in many tissues other than the small intestine, where calcium from food is absorbed. These include muscles, brain, prostate, breast, colon, and immune cells. We have to believe that these vitamin D receptors serve a function since diseases in these organs have been associated with vitamin D deficiency.
Additionally, vitamin D levels have recently been found to be significantly low in many age groups. The previous recommendation of 400 IU per day is too low. The new recommendation is 800-1200 IU daily, especially for people who do not have significant skin sun exposure like the elderly or those who are inactive. Vitamin D is found in a limited number of foods such as cheese, butter, vitamin D fortified milk, oily fish and eggs.
Exercise
 We know that astronauts in the weightlessness of space lose calcium from their bones at a fast rate. This means, as we have known for a long time, that the force of gravity exerts a strong beneficial effect on our bones. Exercise and gravity together help to build bone strength in the young and maintain it thereafter. The type of exercise is important. It should be exercise where the long bones of the legs and those of the spine are stressed. Walking, running, yard work, and any sport where running is a prominent feature are particularly good. This includes field hockey, soccer, track, basketball, tennis, etc. Bicycling and weight lifting are not quite as helpful for strengthening bones. Young girls are especially encouraged to engage in these sports as their bones never become as large or as strong as mens'. A girl reaches her maximum bone density at about age 20. After that, there is a steady loss of calcium in bone until menopause when it worsens.
Medications
Cortisone and prednisone belong to a group of medications that are used for a variety of conditions such as asthma and intestinal disorders like Crohn's disease. When these drugs are taken for a prolonged period, even in very small doses, bone loss occurs. These patients, in particular, need to keep track of their bone density and maintain a good intake of calcium-rich food, supplemental calcium, weight-bearing exercise, vitamin D, and perhaps prebiotic soluble plant fiber.
The Don'ts
Yes, there are a number of things one should avoid if there is a concern about osteoporosis. The following habits aggravate bone loss and promote osteoporosis:
- Excessive alcohol
- Cigarette smoking
- Excessive caffeine
Medical Testing
For those concerned about how their bones will look in the future, it may not be too soon to get baseline testing as a reference point. A bone density test may be appropriate. In addition, since vitamin D deficiency is so prevalent by current standards, a blood measurement of vitamin D level may be warranted.
The Do's
Parents with pre-teen or teenage girls guide the health of their daughters. As noted, a girl reaches her maximum bone density at about age 20. Thereafter, it cannot be increased. Indeed, even at this early age, there is a steady, slow decline of bone density until menopause when it usually increases more rapidly. So, it is the parents' responsibility to ensure that their daughter's bones are as strong as possible when they are young.
- Adequate calcium in food and supplements
- Adequate vitamin D
- Leg and spine stressing exercise
- Increased intake of foods or supplements that contain prebiotics fibers
Prebiotic Foods
 A prebiotic is a fiber found in some plants that reaches the colon undigested. There it is fermented by colon bacteria. This results in significant health benefits to the colon and the body. Inulin, a part of which is called oligofructose, is by far the most researched of these food fibers. Presently, most Americans ingest only 1-2 grams a day of this fiber. Europeans eat three times this amount. Inulin is found in small quantities in wheat and onions where Americans get 90% of their inulin. It is also found in bananas, leeks, chicory, artichokes, and garlic among others.
For a full essay on prebiotics please click here.
Oligofructose Enriched Inulin - A Prebiotic Food Fiber
Medical researchers have studied a mixture of two prebiotics fibers, oligofructose and inulin, for its affect on calcium and magnesium absorption. Surprisingly, it has been found to significantly increase calcium absorption in the colon. When these fibers are fermented by the good colon bacteria, the acidity in the colon increases. This acidity appears to be related to increased calcium absorption.
Whatever the reason, some remarkable things have recently been demonstrated. In young teenage girls who took oligofructose enriched inulin (our product is Prebiotin™) for one year, there was significantly increased absorption of calcium. Along with this, even more remarkably, the bone density of these girls increased 20%.
Any increase in the bone density of adolescent females should be an asset for the rest of her life. It means that the gradual downhill loss of bone mass begins at a higher level and so the girl should have stronger bones the rest of her life.
Oligofructose enriched inulin (Prebiotin™) is the only prebiotics food fiber with this demonstrated benefit. The recommended dose is 8 grams per day.
For a full essay on prebiotics please click here.
Summary
DO
- Eat and drink adequate calcium containing foods
- Take calcium supplements if needed
- Do leg and spine stressing exercise
- Get adequate vitamin D from sun, food and/or supplements
- Increase intake of foods that contain prebiotics fibers. Consider a supplement
DON'T
- Consume excessive caffeine or alcohol
- Smoke cigarettes
DILEMMA
- When steroids such as cortisone or prednisone are needed, consult with your physician.
POSSIBLE PERIODIC TESTING
- Bone Density
- Vitamin D blood level
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Medical References
Several studies in animals and humans have shown positive effects of
nondigestible oligosaccharides (NDO) on mineral absorption and
metabolism and bone composition and architecture. These include inulin,
oligofructose, fructooligosaccharides, galactooligosaccharides, soybean
oligosaccharide, and also resistant starches, sugar alcohols, and
difructose anhydride. A positive outcome of dietary prebiotics is
promoted by a high dietary calcium content up to a threshold level and
an optimum amount and composition of supplemented prebiotics. There
might be an optimum composition of fructooligosaccharides with
different chain lengths (synergy products). The efficacy of dietary
prebiotics depends on chronological age, physiological age, menopausal
status, and calcium absorption capacity. There is evidence for an
independent probiotic effect on facilitating mineral absorption.
Synbiotics, i.e., a combination of probiotics and prebiotics, can
induce additional effects. Wheth er a low content of habitual NDO would
augment the effect of dietary prebiotics or synbiotics remains to be
studied. The underlying mechanisms are manifold: increased solubility
of minerals because of increased bacterial production of short-chain
fatty acids, which is promoted by the greater supply of substrate; an
enlargement of the absorption surface by promoting proliferation of
enterocytes mediated by bacterial fermentation products, predominantly
lactate and butyrate; increased expression of calcium-binding proteins;
improvement of gut health; degradation of mineral complexing phytic
acid; release of bone-modulating factors such as phytoestrogens from
foods; stabilization of the intestinal flora and ecology, also in the
presence of antibiotics; stabilization of the intestinal mucus; and
impact of modulating growth factors such as polyamines. In conclusion,
prebiotics are the most promising but also best investigated substances
with respect to a bone-health-promoting potential, compared with
probiotics and synbiotics. The results are more prominent in animal
models, where more studies have been performed, than in human studies,
where experimental conditions are more difficult to control.
BACKGROUND: Short-term studies in adolescents have generally shown an
enhancement of calcium absorption by inulin-type fructans. Results have
been inconsistent; however, and no studies have been conducted to
determine whether this effect persists with long-term use. OBJECTIVE:
The objective was to assess the effects on calcium absorption and bone
mineral accretion after 8 wk and 1 y of supplementation with an
inulin-type fructan. DESIGN: Pubertal adolescents were randomly
assigned to receive 8 g/d of a mixed short and long degree of
polymerization inulin-type fructan product (fructan group) or
maltodextrin placebo (control group). Bone mineral content and bone
mineral density were measured before randomization and after 1 y.
Calcium absorption was measured with the use of stable isotopes at
baseline and 8 wk and 1 y after supplementation. Polymorphisms of the
Fok1 vitamin D receptor gene were determined. RESULTS: Calcium
absorption was significantly g reater in the fructan group than in the
control group at 8 wk (difference: 8.5 +/- 1.6%; P < 0.001) and at 1
y (difference: 5.9 +/- 2.8%; P = 0.04). An interaction with Fok1
genotype was present such that subjects with an ff genotype had the
least initial response to fructan. After 1 y, the fructan group had a
greater increment in both whole-body bone mineral content (difference:
35 +/- 16 g; P = 0.03) and whole-body bone mineral density (difference:
0.015 +/- 0.004 g/cm(2); P = 0.01) than did the control group.
CONCLUSION: Daily consumption of a combination of prebiotic short- and
long-chain inulin-type fructans significantly increases calcium
absorption and enhances bone mineralization during pubertal growth.
Effects of dietary factors on calcium absorption may be modulated by
genetic factors, including specific vitamin D receptor gene
polymorphisms.
In humans, there is increasing evidence that the colon can absorb
nutritionally significant amounts of calcium, and this process may be
susceptible to dietary manipulation by fermentable substrates,
especially inulin-type fructans. Inulin-type fructans can modulate
calcium absorption because they are resistant to hydrolysis by
mammalian enzymes and are fermented in the large intestine to produce
short-chain fatty acids, which in turn reduce luminal pH and modify
calcium speciation, and hence solubility, or exert a direct effect on
the mucosal transport pathway. Quite a few intervention studies showed
an improvement of calcium absorption in adolescents or young adults by
inulin-type fructans. In the same way, a positive effect has been
reported in older women.
Nondigestible oligosaccharides (NDOs) have been found to stimulate
absorption of several minerals and to improve mineralization of bone.
Hence, these substances are potential ingredients for "functional
foods." In addition to a nutritional effect, functional foods have
physiologic and psychological benefits that result in improved health
or reduced risk of chronic disease. Most of the scientific evidence for
the functional effects of NDOs is based on animal experiments in which
NDOs increased the availability of calcium, magnesium, zinc, and iron.
This stimulatory effect of some NDOs is assumed to be mainly due to
their prebiotic character. A prebiotic is defined as a substrate or
food ingredient that is nondigestible for the host but is fermented
selectively by some of the intestinal microflora. Thus, it stimulates
the growth and activity of bacteria with beneficial consequences for
the host's health. Recently, these findings were confirmed in human
studies for s ome NDOs. The effects seem to be specific for the type of
carbohydrate and are likely related to the rate of fermentation by the
intestinal flora and appear to depend on the ingested dose.
Contradictory results of the effect of prebiotics in literature may be
due to the experimental design because the effect of NDOs depends on
the dose, the time of administration, the content of calcium in the
diet, the part of the skeleton investigated, and the age of the
subjects studied.
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